Please tell me there isn't a financial incentive behind this. The only thing worse than doctors suggesting opioids to those who might not otherwise consider it is doctors suggesting death to those who might not otherwise consider it.
The problem is that the government and health care institutions have a conflict of interest in euthanasia.
A citizen that is costly to you? Wouldn't it be convenient if they disappeared? Wouldn't it be even better if they believed this was in their own best interests?
I think a legitimate argument can be made that in many of these cases, Canada is simply killing its citizens rather than try to provide services, and essentially blaming it on the citizens or fate.
I'm a huge supporter of assisted suicide. I believe it's a fundamental form of autonomy. But I also believe that people can be in positions where they are incapable of offering informed consent, and also strongly believe those in a position to assist cannot be in a place to assist in deciding. There needs to be a firewall in between. Probably a step further, in that there needs to be someone openly arguing against euthanasia as a matter of course, to ensure there is an advocate for that position.
Think of it this way. Let's say a person is mentally incapable of consenting — they have a severe cognitive disability, or are a child. They are falsely accused by the state of a capital offense, because it unethically benefits the state (eg, to protect corrupt police). If they convince the accused of their guilt, does it make ethically acceptable? What if the accused is capable of consent, but is lied to and brainwashed about their guilt, and manipulated into believing they are guilty?
In those cases, doesn't it still make sense to have a legal advocate for their innocence?
How is that fundamentally different?
1. Let fully lucid patients make a decision to die.
2. Let partially lucid patients make a decision to die.
3. Let family members of non-lucid patient makes a decision to die.
4. Let doctor make a decision for a patient who "would clearly want to die if they could speak".
Canadian elections are generally won in suburbs, so Provincial governments are generally hesitant to increase quality of care via tax revenues. This usually results in discussions of federal funding to improve care outcomes.[1]
[1] https://globalnews.ca/news/8590853/canadian-premiers-new-pol...
"Roger Foley, who has a degenerative brain disorder and is hospitalized in London, Ontario, was so alarmed by staffers mentioning euthanasia that he began secretly recording some of their conversations.
"In one recording obtained by the AP, the hospital’s director of ethics told Foley that for him to remain in the hospital, it would cost “north of $1,500 a day.” Foley replied that mentioning fees felt like coercion and asked what plan there was for his long-term care.
"“Roger, this is not my show,” the ethicist responded. “My piece of this was to talk to you, (to see) if you had an interest in assisted dying.”
"Foley said he had never previously mentioned euthanasia. The hospital says there is no prohibition on staff raising the issue."
I'm shocked. For the benefit of the doubt, since the quote doesn't include broader context, it's possible that the information was relevant in some way independent of guilting the patient, or the ethicist was being unintentionally awkward.
But given the information presented in the article, it's not a good look for the hospital, which should be prioritizing patient outcomes far above cost savings.
There is no financial incentive behind it on a personal level for doctors, given Canada's one-payer medical system, and euthanasia is counter to many doctors' interpretation of the Hypocratic oath.
You could argue that on a system-level there is an incentive to encourage euthanasia, since it could take expensive terminal patients off the bill. This bit does make many people (myself included) uncomfortable and there definitely needs to be checks and balances in place.
The details of compensation can easily encourage one time injections over long term care.
Even if the injection is poison.
I know for a fact that “bounty” type programs are used by Canadian public health authorities, and for-profit actors make money from them.
I don’t know if this extends to long-term care scenarios, but there’s nothing about the way the Canadian health system is structured that offers strong protection against perverse incentives.
Arguably, the horrible US for-profit health system offers stronger protection against this. A dead patient can’t be charged for more services. But a system that equates medical consumption with good care has it’s own set of problems too obvious to mention.
> Arguably, the horrible US for-profit health system offers stronger protection against this. A dead patient can’t be charged for more services. But a system that equates medical consumption with good care has it’s own set of problems too obvious to mention.
This isn't stronger protection; it just creates a different perverse incentive to effectively drag out someone's suffering.
Does that structure offer strong protection against perverse incentives in all provinces?
This article provides evidence to the contrary:
"Roger Foley, who has a degenerative brain disorder and is hospitalized in London, Ontario, was so alarmed by staffers mentioning euthanasia that he began secretly recording some of their conversations.
In one recording obtained by the AP, the hospital’s director of ethics told Foley that for him to remain in the hospital, it would cost “north of $1,500 a day.” Foley replied that mentioning fees felt like coercion and asked what plan there was for his long-term care."
That said, I feel like the point here was that it wasn't likely to be pushed at people who hadn't asked, and yet it was, not that it was uniquely bad coming from a doctor vs. an administrator.
If the Director of Ethics and their staff think this is appropriate, it'd be more surprising if the doctors didn't engage in the same.
But in addition to the case from Foley quoted by another commenter, the article backs it up with another claim given by a named source: "Frazee cited the case of Candice Lewis, a 25-year-old woman who has cerebral palsy and spina bifida. Lewis’ mother, Sheila Elson, took her to an emergency room in Newfoundland five years ago. During her hospital stay, a doctor said Lewis was a candidate for euthanasia and that if her mother chose not to pursue it, that would be “selfish,” Elson told the Canadian Broadcasting Corporation."
So, it looks credible that it's happening in practice. I can only speculate as to why, but I revised my initial belief because it was hypothetical, after reading about the accounts that look objective.
Maybe people need to take some responsibility, instead of arguing the existence of Dr Evils in medicine.
https://www.discovermagazine.com/mind/the-shocking-truth-of-...
In general I agree with you, but there are s lot of really people that fall for scams that seems hard to fall for for most of us.